FM Monthly Meter Reading Recorder

• Xerox meter retrieval procedure

Please provide the following contact information and meter readings:

Account Name
Contact Name
E-mail

For KIP enter meter in the "A" space provided below. For Xerox enter in the "A" and "B" space below.
Enter meter "A" here.
Enter meter "B" here. (Xerox only)		Special notes:

Contact Info: Jared Mossman
Copyright ? 2003 [Burks Digital]. All rights reserved.
Revised: 04/18/08